Radically Redefining Birth Work

Here at the Center for Sacred Window Studies, we share voices from many perspectives and backgrounds. We believe that the sacred weeks post birth, and the experience of humanity is experienced in countless ways. We learn by listening to one another and honoring our stories. The views and opinions of our writers do not necessarily reflect the mission, viewpoints or opinions of the Center for Sacred Window Studies.

It was the midst of the pandemic and I had just begun my journey on studying to become a postpartum doula rooted in the wisdom of Ayurveda.

I had come to this journey after spending more than a decade working as a nurse and birth doula. What I took away from that professional experience is that the health care experience, the birthing experience and access to care and nourishment is deeply unequal and racist in the United States.

I have been questioning how the postpartum doula community and birth workers as a whole can radically redefine what is possible.

The pandemic and the Black Lives Matter movement have highlighted the glaring violations, the oppression and state-sanctioned discrimination that birthing people – and especially Black, Indigenous, and People of Color individuals – experience on a daily basis. I have been questioning how the postpartum doula community and birth workers as a whole can radically redefine what is possible. How do we provide care and nurture new parents in this deeply transformational moment and be activists in creating a new paradigm of care?

When we lack what we really need in postpartum

My personal philosophy on postpartum care, and why I am deeply passionate about it, is that I have seen the ways in which lack of support, nourishment and community can continue the cycle of intergenerational trauma and isolation, as well as impact the birthing person’s future health. 

Care in the U.S. has become a luxury good. Doula care is expensive and thus restricted to the few. I am inspired by the work of BIPOC doulas and midwives who are leading the way in decolonizing and reshaping equity and working towards bringing this work to as many people as possible. It is also time for us to reimagine the structures and power holders in the fields of birth and infant feeding. 

As we met each week, we learned together and reflected on the past and the present.

I was deeply grateful when my friend Aileen shared an offering by accomplished journalist, writer and activist Kimberly Seals Allers on the intersection of birth, infant feeding, race and policy. I joined a diverse group of policy makers, health care providers, doulas, activists and birth workers from all across the world in identifying strategies and co-creating a new model of equitable care.  

As we met each week, we learned together and reflected on the past and the present. At the end of the session, we collectively came up with seven themes – each a call to action to remake the landscape and infrastructure of care. I want to share these themes and how I believe postpartum care can be offered under these guiding principles.

Below I lay out these seven guiding principles and my thoughts on how they can inform and radicalize postpartum care.

Universal Health Care

High quality, patient-centered care that values prevention and broadens the scope of coverage to include essential services like doula support and midwifery care. Birthing centers can start to be central in providing birthing services through increased funding and in network coverage.

Family-Focused Policies

The pandemic has shown alternate work schedules, settings and flexibility can be possible. Reimagine established culture on working hours and working from an office. All parents and caregivers should have access to at least 6 months of paid leave with job security. We should create a culture of flexible work opportunities.

Revolution in Care

Our new definition of care extends beyond medications and procedures. Care involves offering trauma-informed, culturally rooted care to support a recovering birther. Extend postpartum care from a brief clinician visit six weeks after birth to in-home follow up visits from a doula or midwife. Include coverage for traditional cultural nourishing food and remove barriers to accessing lactation consultants and human donor milk.

De-center Hospitals

We need more birthing centers to offer birth in a safe and comforting setting and extend it beyond the confines of a hospital. Allow midwives and doulas to receive compensation under health plan coverage and rally doctor-led lobby groups to stop criminalizing community-centered birth workers.

Messaging and Advocacy

Join and donate to organizations that are working towards ending disparities among Black and Indigenous birthing parents. Mobilize and ask how you can galvanize the resources within your community towards activism. Organize and vote to ensure access to inclusive health care. 

Education

Educational institutions and providers are called to center equity and BIPOC people, and to receive professional support to decolonize their educational spaces and instructional language. Honor ancestral wisdom and question the supremacy of research studies and data-driven information to dictate postpartum care.

Centering Community

Our collective health and freedom is interconnected, and that calls for creating care that is integrated, accessible and not exclusionary. Postpartum caregivers who are privileged are called in to speak up, highlight voices in their community and leverage their power to broaden access. Offer services at various price levels, fund training programs and sponsor caregivers from BIPOC communities. Become sustaining supporters of healing collectives and community-run programs and health centers.

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